AAN: Computers, Exercise Linked to Lower MCI Risk

Action Points

Explain to interested patients that this study suggests that moderate exercise and computer use late in life may be linked to a lower risk of cognitive impairment.

Point out that the study documents associations but cannot determine causality.

Note that this study was published as an abstract and presented at a conference. These data and conclusions should be considered preliminary until published in a peer-reviewed journal.

TORONTO -- Moderate physical exercise, combined with computer use late in life, is associated with a lower risk of mild cognitive impairment, a researcher said here.

In a cross-sectional analysis of participants in an aging study, both elements were separately associated with a lower risk of the impairment, according to Yonas Geda, MD, of the Mayo Clinic in Rochester, Minn.

But they also showed a significant additive interaction that created a synergistic effect, Geda reported at the annual meeting here of the American Academy of Neurology.

On the other hand, he cautioned, it's difficult to assign cause and effect on the basis of a cross-sectional study. For instance, Geda said, "maybe a person who can use a computer does not have cognitive issues (while) a person with cognitive issues may shy away from computers."

The finding of the synergistic interaction comes from the population-based Mayo Clinic Study of Aging, he said. Data from the study on the link between exercise and the risk of impairment were reported earlier this year. (See Exercise May Aid Cognitive Function)

For this analysis, a random sample of 926 elderly participants, ages 70 through 90 years, completed questionnaires on physical exercise, cognitive activities, and caloric intake during the previous year.

At that point, Geda said, all of the participants were regarded as nondemented; a diagnosis of mild cognitive impairment, if appropriate, came later, as a "downstream event." Using that later diagnosis, 817 participants were cognitively normal and 109 had mild cognitive impairment.

The researchers found significant differences between the two groups. Normal participants were significantly younger, better educated, less likely to suffer from depression, and had fewer medical comorbidities (at P<0.001, P=0.018, P<0.001, and P=0.004, respectively).

When the researchers controlled for those factors, in a multivariate regression analysis, they found:

Any frequency of moderate exercise (versus none) was protective. The odds ratio was 0.64, with a 95% confidence interval from 0.42 to 0.98, which was significant at P=0.04.

Any frequency of computer use (also versus none) was protective. The odds ratio was 0.56, with a 95% confidence interval from 0.36 to 0.89, which was significant at P=0.001.

Caloric intake was deleterious. The odds ratio for each increase of 100 kilocalories was 1.04, with 95% confidence interval from 1.01 to 1.06, which was significant at P=0.001.

When the researchers controlled for caloric intake as well as other the possible confounders, Geda said, they found that physical exercise and computer use had an additive interaction that was significant at P=0.01, although there was no multiplicative interaction.

He said the researchers can't rule our recall bias that might have skewed the results. But a fortunate accident, he said, gives them added confidence.

"By mistake, 80 participants completed the survey on two consecutive years," he said, although they were only supposed to answer it once.

When the researchers analyzed those questionnaires, he said, they found no significant differences between the consecutive years, suggesting that the survey elicited "reliable responses."

In response to questions, Geda said only computer use -- of other possible cognition-enhancing activities, such as reading -- remained significant in the analysis. He added that the researchers did not distinguish between different types of computer use.

The findings come on top of previous evidence for the benefits of both types of activity, said Julie Schneider, MD, of Rush University Medical Center in Chicago, who moderated the session at which the research was presented but who was not part of the study.

The difference with the Mayo study, she told MedPage Today, is that it suggests that "both are better than either one alone."

But, she said, more studies are needed to clarify the relationship.

The study had support from the NIH, the Harold Amos Medical Faculty Development Program (RWJ Foundation), and the Robert H. and Clarice Smith and Abigail Van Buren Alzheimer's Disease Research Program. The researchers had no conflicts.

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